Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

College Street Medical Group, PLLC

Organization Family Medicine Physician · NPI 1912233289

College Street Medical Group, PLLC is a Family Medicine Physician in Beaumont, Texas. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5755 College St
Beaumont, TX 77707-3518
Phone: (409) 840-9300
Fax: (409) 842-4960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1912233289
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bodre Rising — Provider/Owner · (409) 840-9300
NPI enumeratedOctober 21, 2009
Last updated in NPPESApril 28, 2011
Mailing address5755 College St, Beaumont, TX 77707-3518

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